Lung Cancer Surveillance After Definitive Curative-Intent Therapy: ASCO Guideline

Author:

Schneider Bryan J.1,Ismaila Nofisat2,Aerts Joachim3,Chiles Caroline4,Daly Megan E.5,Detterbeck Frank C.6,Hearn Jason W.D.1,Katz Sharyn I.7,Leighl Natasha B.8,Levy Benjamin9,Meyers Bryan10,Murgu Septimiu11,Nekhlyudov Larissa12,Santos Edgardo S.13,Singh Navneet14,Tashbar Joan15,Yankelevitz David16,Altorki Nasser17

Affiliation:

1. University of Michigan Health System, Ann Arbor, MI

2. American Society of Clinical Oncology, Alexandria, VA

3. Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands

4. Wake Forest Health Science Center, Winston-Salem, NC

5. University of California Davis Comprehensive Cancer Center, Sacramento, CA

6. Yale University, New Haven, CT

7. University of Pennsylvania Perelman School of Medicine, Philadelphia, PA

8. Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada

9. Johns Hopkins Sidney Kimmel Cancer Center at Sibley Memorial Hospital, Washington, DC

10. Washington University, St Louis, MO

11. University of Chicago, Chicago, IL

12. Brigham and Women’s Hospital, Boston, MA

13. Florida Precision Oncology/21st Century Oncology, Aventura, FL

14. Postgraduate Institute of Medical Education and Research, Chandigarh, India

15. Circle of Hope for Cancer Research, Orlando, FL

16. Mount Sinai Hospital, New York, NY

17. Weill Cornell Medicine/Cornell University, New York, NY

Abstract

PURPOSE To provide evidence-based recommendations to practicing clinicians on radiographic imaging and biomarker surveillance strategies after definitive curative-intent therapy in patients with stage I-III non–small-cell lung cancer (NSCLC) and SCLC. METHODS ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, radiology, primary care, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2000 through 2019. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 14 relevant studies to inform the evidence base for this guideline. RECOMMENDATIONS Patients should undergo surveillance imaging for recurrence every 6 months for 2 years and then annually for detection of new primary lung cancers. Chest computed tomography imaging is the optimal imaging modality for surveillance. Fluorodeoxyglucose positron emission tomography/computed tomography imaging should not be used as a surveillance tool. Surveillance imaging may not be offered to patients who are clinically unsuitable for or unwilling to accept further treatment. Age should not preclude surveillance imaging. Circulating biomarkers should not be used as a surveillance strategy for detection of recurrence. Brain magnetic resonance imaging should not be used for routine surveillance in stage I-III NSCLC but may be used every 3 months for the first year and every 6 months for the second year in patients with stage I-III small-cell lung cancer who have undergone curative-intent treatment.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

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